AB43: Bill Text

AB43,,2670 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent of the poverty line may become eligible for coverage under this section if the difference between the pregnant woman’s family income and the applicable income limit under sub. (4) (a) is obligated or expended for any member of the pregnant woman’s family for medical care or any other type of remedial care recognized under state law or for personal health insurance premiums or for both. Eligibility obtained under this subdivision continues without regard to any change in family income for the balance of the pregnancy and to the last day of the month in which the 60th day or, if approved by the federal government, the 90th 365th day after the last day of the woman’s pregnancy falls. Eligibility obtained by a pregnant woman under this subdivision extends to all pregnant women in the pregnant woman’s family.

AB43,1126 Section 1126. 49.485 of the statutes is renumbered 20.9315 (19) and amended to read:

AB43,,2672 20.9315 (19) Whoever knowingly presents or causes to be presented to any officer, employee, or agent of this state a false claim for medical assistance shall forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of the damages that were sustained by the state or would have been sustained by the state, whichever is greater, as a result of the false claim. The attorney general may bring an action on behalf of the state to recover any forfeiture incurred under this section.

AB43,1127 Section 1127. 49.686 (3) (d) of the statutes is amended to read:

AB43,,2674 49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (4) (a) 8. or (11).

AB43,1128 Section 1128. 49.79 (1) (b) of the statutes is amended to read:

AB43,,2676 49.79 (1) (b) “Controlled substance” has the meaning given in 21 USC 802 (6), except that “controlled substance” does not include tetrahydrocannabinols in any form, including tetrahydrocannabinols contained in marijuana, obtained from marijuana, or chemically synthesized.

AB43,1129 Section 1129. 49.79 (7m) of the statutes is created to read:

AB43,,2678 49.79 (7m) Healthy eating incentives. (a) In this subsection, “fruit and vegetables” means “any variety of fresh, canned, dried, or frozen whole or cut fruits or vegetables without added sugars, fats, oils, or salt.

AB43,,2679 (b) Subject to pars. (c) and (d), from the appropriation under s. 20.435 (4) (bu), the department shall establish and implement a statewide healthy eating incentives Double Up Food Bucks pilot program under the federal Gus Schumacher Nutrition Incentive Program to match benefit amounts spent by recipients under the food stamp program on fruits and vegetables from participating retailers with additional benefit amounts to be used for the purchase of fruits and vegetables.

AB43,,2680 (c) The department shall do all of the following, on a schedule determined by the department:

AB43,,2681 1. Submit to the U.S. department of agriculture a request for a waiver or any other federal approval necessary to allow the department to implement the program under this subsection.

AB43,,2682 2. Seek any available moneys, including federal moneys under the federal Gus Schumacher Nutrition Incentive Program, to fund implementation of the program under this subsection.

AB43,,2683 (d) If the U.S. department of agriculture disapproves the request under par. (c) 1. or if the department is unable to obtain sufficient funding for the program, the department may not implement the program under this subsection.

AB43,1130 Section 1130. 49.79 (7s) of the statutes is created to read:

AB43,,2685 49.79 (7s) Payment processing program. From the appropriation under s. 20.435 (4) (bu), the department shall administer a payment processing program to provide to farmers’ markets and farmers who sell directly to consumers electronic benefit transfer and credit and debit card processing equipment and services, including electronic benefit transfer for the food stamp program. To participate in the payment processing program, the vendor that is under contract to process the electronic benefit transfer and credit and debit card transactions shall also process any local purchasing incentives, even if those local purchasing incentives are funded by a local 3rd-party entity.

AB43,1131 Section 1131. 49.79 (9) (a) 1g. of the statutes is amended to read:

AB43,,2687 49.79 (9) (a) 1g. Except as provided in subds. 2. and 3., beginning October 1, 2019, the department shall require, to the extent allowed by the federal government, all able-bodied adults without dependents in this state to participate in the employment and training program under this subsection, except for able-bodied adults without dependents who are employed, as determined by the department. The department may require other able individuals who are 18 to 60 years of age, or a subset of those individuals to the extent allowed by the federal government, who are not participants in a Wisconsin Works employment position to participate in the employment and training program under this subsection.

AB43,1132 Section 1132. 49.79 (9) (d) of the statutes is repealed.

AB43,1133 Section 1133. 49.79 (9) (f) of the statutes is repealed.

AB43,1134 Section 1134. 49.791 of the statutes is repealed.

AB43,1135 Section 1135. 49.90 (4) of the statutes is amended to read:

AB43,,2692 49.90 (4) The circuit court shall in a summary way hear the allegations and proofs of the parties and by order require maintenance from these relatives, if they have sufficient ability, considering their own future maintenance and making reasonable allowance for the protection of the property and investments from which they derive their living and their care and protection in old age, in the following order: First the husband or wife spouse; then the father and the mother parents; and then the grandparents in the instances in which sub. (1) (a) 2. applies. The order shall specify a sum which that will be sufficient for the support of the dependent person under sub. (1) (a) 1. or the maintenance of a child of a dependent person under sub. (1) (a) 2., to be paid weekly or monthly, during a period fixed by the order or until the further order of the court. If the court is satisfied that any such relative is unable wholly to maintain the dependent person or the child, but is able to contribute to the person’s support or the child’s maintenance, the court may direct 2 or more of the relatives to maintain the person or the child and prescribe the proportion each shall contribute. If the court is satisfied that these relatives are unable together wholly to maintain the dependent person or the child, but are able to contribute to the person’s support or the child’s maintenance, the court shall direct a sum to be paid weekly or monthly by each relative in proportion to ability. Contributions directed by court order, if for less than full support, shall be paid to the department of health services or the department of children and families, whichever is appropriate, and distributed as required by state and federal law. An order under this subsection that relates to maintenance required under sub. (1) (a) 2. shall specifically assign responsibility for and direct the manner of payment of the child’s health care expenses, subject to the limitations under subs. (1) (a) 2. and (11). Upon application of any party affected by the order and upon like notice and procedure, the court may modify such an order. Obedience to such an order may be enforced by proceedings for contempt.

AB43,1136 Section 1136. 50.01 (1b) of the statutes is repealed.

AB43,1137 Section 1137. 50.08 (2) of the statutes is amended to read:

AB43,,2695 50.08 (2) A physician, an advanced practice registered nurse prescriber certified who may issue prescription orders under s. 441.16 441.09 (2), or a physician assistant who prescribes a psychotropic medication to a nursing home resident who has degenerative brain disorder shall notify the nursing home if the prescribed medication has a boxed warning under 21 CFR 201.57.

AB43,1138 Section 1138. 50.09 (1) (a) (intro.) of the statutes is amended to read:

AB43,,2697 50.09 (1) (a) (intro.) Private and unrestricted communications with the resident’s family, physician, physician assistant, advanced practice registered nurse prescriber, attorney, and any other person, unless medically contraindicated as documented by the resident’s physician, physician assistant, or advanced practice registered nurse prescriber in the resident’s medical record, except that communications with public officials or with the resident’s attorney shall not be restricted in any event. The right to private and unrestricted communications shall include, but is not limited to, the right to:

AB43,1139 Section 1139. 50.09 (1) (f) 1. of the statutes is amended to read:

AB43,,2699 50.09 (1) (f) 1. Privacy for visits by spouse or domestic partner. If both spouses or both domestic partners under ch. 770 are residents of the same facility, the spouses or domestic partners shall be permitted to share a room unless medically contraindicated as documented by the resident’s physician, physician assistant, or advanced practice registered nurse prescriber in the resident’s medical record.

AB43,1140 Section 1140. 50.09 (1) (h) of the statutes is amended to read:

AB43,,2701 50.09 (1) (h) Meet with, and participate in activities of social, religious, and community groups at the resident’s discretion, unless medically contraindicated as documented by the resident’s physician, physician assistant, or advanced practice registered nurse prescriber in the resident’s medical record.

AB43,1141 Section 1141. 50.09 (1) (k) of the statutes is amended to read:

AB43,,2703 50.09 (1) (k) Be free from mental and physical abuse, and be free from chemical and physical restraints except as authorized in writing by a physician, physician assistant, or advanced practice registered nurse prescriber for a specified and limited period of time and documented in the resident’s medical record. Physical restraints may be used in an emergency when necessary to protect the resident from injury to himself or herself or others or to property. However, authorization for continuing use of the physical restraints shall be secured from a physician, physician assistant, or advanced practice registered nurse prescriber within 12 hours. Any use of physical restraints shall be noted in the resident’s medical records. “Physical restraints” includes, but is not limited to, any article, device, or garment that interferes with the free movement of the resident and that the resident is unable to remove easily, and confinement in a locked room.

AB43,1142 Section 1142. 50.36 (3s) of the statutes is created to read:

AB43,,2705 50.36 (3s) The department shall require a hospital that provides emergency services to have sufficient qualified personnel at all times to manage the number and severity of emergency department cases anticipated by the location. At all times, a hospital that provides emergency services shall have on-site at least one physician who, through education, training, and experience, specializes in emergency medicine.

AB43,1143 Section 1143. 50.49 (1) (b) (intro.) of the statutes is amended to read:

AB43,,2707 50.49 (1) (b) (intro.) “Home health services” means the following items and services that are furnished to an individual, who is under the care of a physician, physician assistant, or advanced practice registered nurse prescriber, by a home health agency, or by others under arrangements made by the home health agency, that are under a plan for furnishing those items and services to the individual that is established and periodically reviewed by a physician, physician assistant, or advanced practice registered nurse prescriber and that are, except as provided in subd. 6., provided on a visiting basis in a place of residence used as the individual’s home:

AB43,1144 Section 1144. 51.036 of the statutes is created to read:

AB43,,2709 51.036 Crisis urgent care and observation facilities. (1) Definitions. In this section:

AB43,,2710 (a) “Crisis” means a situation caused by an individual’s apparent mental or substance use disorder that results in a high level of stress or anxiety for the individual, persons providing care for the individual, or the public and that is not resolved by the available coping methods of the individual or by the efforts of those providing ordinary care or support for the individual.

AB43,,2711 (b) “Crisis urgent care and observation facility” means a treatment facility that admits an individual to prevent, de-escalate, or treat the individual’s mental health or substance use disorder and includes the necessary structure and staff to support the individual’s needs relating to the mental health or substance use disorder.

AB43,,2712 (2) Certification required; exemption. (a) The department shall establish a certification process for crisis urgent care and observation facilities and may establish criteria by rule for the certification of crisis urgent care and observation facilities. The department may limit the number of certifications it grants to operate crisis urgent care and observation facilities. No person may operate a crisis urgent care and observation facility without a certification under this section. The department shall establish by rule a process for crisis urgent care and observation facilities to apply to the department for certification of the facility for the receipt of funds for services provided as a benefit to a recipient under the Medical Assistance program.

AB43,,2713 (b) A crisis urgent care and observation facility certified under this section is not subject to facility regulation under ch. 50, unless otherwise required due to the facility’s licensure or certification for other services or purposes. A crisis urgent care and observation facility is not a hospital under s. 50.32 and nothing in this paragraph limits services a hospital may provide under s. 50.32.

AB43,,2714 (c) A crisis urgent care and observation facility certified under this section shall do all of the following:

AB43,,2715 1. Accept referrals for crisis services for both youths and adults, including involuntary patients under emergency detention, voluntary patients, walk-ins, and individuals brought by law enforcement, emergency medical responders, and other emergency medical services practitioners.

AB43,,2716 2. Abstain from having a requirement for medical clearance before admission assessment.

AB43,,2717 3. Provide assessments for physical health, substance use disorder, and mental health.

AB43,,2718 4. Provide screens for suicide and violence risk.

AB43,,2719 5. Provide medication management and therapeutic counseling.

AB43,,2720 6. Provide coordination of services for basic needs.

AB43,,2721 7. Have adequate staffing 24 hours a day, 7 days a week, with a multidisciplinary team including, as needed, psychiatrists or psychiatric nurse practitioners, nurses, licensed clinicians capable of completing assessments and providing necessary treatment, peers with lived experience, and other appropriate staff.

AB43,,2722 8. Allow for voluntary and involuntary treatment of individuals in crisis as a means to avoid unnecessary placement of those individuals in hospital inpatient beds and allow for an effective conversion to voluntary stabilization when warranted in the same setting.

AB43,,2723 (3) Admission. (a) A crisis urgent care and observation facility certified under this section may accept individuals for voluntary stabilization, observation and treatment, including for assessments for mental health or substance use disorder, screening for suicide and violence risk, and medication management and therapeutic counseling.

AB43,,2724 (b) A crisis urgent care and observation facility certified under this section may accept individuals for emergency detention under s. 51.15 if the facility agrees to accept the individual. A county crisis assessment under s. 51.15 (2) (c) is required prior to acceptance of an individual for purposes of emergency detention at a crisis urgent care and observation facility certified under this section. Medical clearance is not required before admission, but the facility shall provide necessary medical services on site.

AB43,,2725 (4) Grants. From the appropriation under s. 20.435 (5) (cj), the department shall award grants to individuals and entities to develop and support crisis urgent care and observation facilities under this section.

AB43,,2726 (5) Rules. The department may promulgate rules to implement this section, including requirements for admitting and holding individuals for purposes of emergency detention. The department may promulgate the rules under this section as emergency rules under s. 227.24. Notwithstanding s. 227.24 (1) (c) and (2), a rule promulgated under this subsection may remain in effect for not more than 24 months. Notwithstanding s. 227.24 (1) (a) and (3), the department is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection.

AB43,1145 Section 1145. 51.042 (3m) of the statutes is created to read:

AB43,,2728 51.042 (3m) Grants. From the appropriation under s. 20.435 (5) (cc), the department shall award grants to organizations to develop and support youth crisis stabilization facilities.

AB43,1146 Section 1146. 51.044 of the statutes is created to read:

AB43,,2730 51.044 Psychiatric residential treatment facilities. (1) Definition. In this section, “psychiatric residential treatment facility” is a non-hospital facility that provides inpatient comprehensive mental health treatment services to individuals under the age of 21 who, due to mental illness, substance use, or severe emotional disturbance, need treatment that can most effectively be provided in a residential treatment facility.

AB43,,2731 (2) Certification required; exemption. (a) No person may operate a psychiatric residential treatment facility without a certification from the department. The department may limit the number of certifications it grants to operate a psychiatric residential treatment facility.

AB43,,2732 (b) A psychiatric residential treatment facility that has a certification from the department under this section is not subject to facility regulation under ch. 48.

AB43,,2733 (3) Rules. The department may promulgate rules to implement this section.

AB43,1147 Section 1147. 51.41 (1d) (b) 4. of the statutes is amended to read:

AB43,,2735 51.41 (1d) (b) 4. A psychiatric mental health advanced practice registered nurse who is suggested by the Milwaukee County board of supervisors. The Milwaukee County board of supervisors shall solicit suggestions from organizations including the Wisconsin Nurses Association for individuals who specialize in a full continuum of behavioral health and medical services including emergency detention, inpatient, residential, transitional, partial hospitalization, intensive outpatient, and wraparound community-based services. The Milwaukee County board of supervisors shall suggest to the Milwaukee County executive 4 psychiatric mental health advanced practice registered nurses for this board membership position.

AB43,1148 Section 1148. 51.44 (5) (bm) of the statutes is created to read:

AB43,,2737 51.44 (5) (bm) Ensure that any child with a level of lead in his or her blood that is 3.5 or more micrograms per 100 milliliters of blood, as confirmed by one venous blood test, is eligible for services under the program under this section.

AB43,1149 Section 1149. 51.441 of the statutes is repealed.

AB43,1150 Section 1150. 51.442 of the statutes is repealed.

AB43,1151 Section 1151. 51.443 of the statutes is created to read:

AB43,,2741 51.443 Mental health consultation program. (1) In this section:

AB43,,2742 (a) “Participating clinicians” includes physicians, nurse practitioners, physician assistants, and medically appropriate members of the care teams of physicians, nurse practitioners, and physician assistants.

AB43,,2743 (b) “Program” means the mental health consultation program under this section.

AB43,,2744 (2) During the fiscal year 2023-24, the department shall contract with the organization that provided consultation services through the child psychiatry consultation program under s. 51.442, 2021 stats., as of January 1, 2023, to administer the mental health consultation program described under this section. In subsequent fiscal years, the department shall contract with the organization that provided consultation services through the child psychiatry consultation program under s. 51.442, 2021 stats., as of January 1, 2023, or another organization to administer the mental health consultation program under this section.

AB43,,2745 (3) The contracting organization under sub. (2) shall administer a mental health consultation program that incorporates a comprehensive set of mental health consultation services, which may include perinatal, child, adult, geriatric, pain, veteran, and general mental health consultation services, and may contract with any other entity to perform any operations and satisfy any requirements under this section for the program.

AB43,,2746 (4) As a condition of providing services through the program, the contracting organization under sub. (2) shall do all of the following:

AB43,,2747 (a) Ensure that all mental health care providers who are providing services through the program have the applicable credential from this state; if a psychiatric professional, that the provider is eligible for certification or is certified by the American Board of Psychiatry and Neurology for adult psychiatry, child and adolescent psychiatry, or both; and if a psychologist, that the provider is registered in a professional organization, including the American Psychological Association, National Register of Health Service Psychologists, Association for Psychological Science, or the National Alliance of Professional Psychology Providers.

AB43,,2748 (b) Maintain the infrastructure necessary to provide the program’s services statewide.

AB43,,2749 (c) Operate the program on weekdays during normal business hours of 8 a.m. to 5 p.m.

AB43,,2750 (d) Provide consultation services under the program as promptly as is practicable.

AB43,,2751 (e) Have the capability to provide consultation services by, at a minimum, telephone and email. Consultation through the program may be provided by teleconference, video conference, voice over Internet protocol, email, pager, in-person conference, or any other telecommunication or electronic means.

AB43,,2752 (f) Provide all of the following services through the program:

AB43,,2753 1. Support for participating clinicians to assist in the management of mental health concerns.

AB43,,2754 2. Triage-level assessments to determine the most appropriate response to each request, including appropriate referrals to any community providers and health systems.

AB43,,2755 3. When medically appropriate, diagnostics and therapeutic feedback.

AB43,,2756 4. Recruitment of other clinicians into the program as participating clinicians when possible.

AB43,,2757 (g) Report to the department any information requested by the department.

AB43,,2758 (h) Conduct annual surveys of participating clinicians who use the program to assess the quality of care provided, self-perceived levels of confidence in providing mental health services, and satisfaction with the consultations and other services provided through the program. Immediately after participating clinicians begin using the program and again 6 to 12 months later, the contracting organization under sub. (2) may conduct assessments of participating clinicians to assess the barriers to and benefits of participation in the program to make future improvements and to determine the participating clinicians’ treatment abilities, confidence, and awareness of relevant resources before and after beginning to use the program.